ABSTRACT
Purpose
To identify clinical markers that are associated to swallowing alterations in infants after surgical repair of congenital heart disease (CHD) and to correlate these markers to the categories on the Risk Adjustment for Congenital Heart Disease 1 (RACHS-1) scale.
Methods
Using the Pediatric Center Database System we conducted a retrospective, observational cohort study on children admitted to the pediatric hospital unit due to CDH. We collected data on specific parameters of a clinical swallowing assessment (SA) and dysphagia was classified according to the Dysphagia Management Staging Scale. We also included demographic and clinical markers and patient´s risk of mortality was determined by using the RACHS-1.
Results
The final study sample consisted of 108 patients. Important findings were: the more severe signs of dysphagia are associated to an increased length of hospital stay (p=0.005); an increased number and duration of orotracheal intubation (p=0.022 and 0.005 respectively); an increased time between hospital admission and SA (p=0.003); an increased time between the surgical procedure and swallowing assessment (0.043); and an increased number of SLP sessions to remove alternate feeding methods and warrant safe oral feeding (p<0.001). No correlations were observed between the infant’s risk of mortality and the altered sings on the clinical swallowing assessment.
Conclusion
The data from this study contributes to the current knowledge that children with heart condition requiring heart surgery in the first month of life have high risk of presenting feeding difficulties and will require prolonged hospital care. No correlation was observed between the categories on RACHS-1 and the altered signs on the clinical swallowing assessment.
Keywords:
Swallowing disorders; Feeding; Swallowing; Congenital heart defect; Mortality